DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Sam, Timothy	DOIID	1295921	NAIC NPN	19486714

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	9/1/2023		3/31/2026
Active	Non Resident	Agent	Property	9/1/2023		3/31/2026
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Bristol West Insurance Company	301655	Agent - Casualty	12/30/2024
Active	Bristol West Insurance Company	301655	Agent - Property	12/30/2024
Active	Farmers Direct Property and Casualty Insurance Company	300957	Agent - Casualty	4/8/2024
Active	Farmers Direct Property and Casualty Insurance Company	300957	Agent - Property	4/8/2024
Active	Farmers Property and Casualty Insurance Company	301237	Agent - Casualty	4/8/2024
Active	Farmers Property and Casualty Insurance Company	301237	Agent - Property	4/8/2024
Inactive	Liberty Mutual Personal Insurance Company	959584	Agent - Casualty	10/20/2023	10/31/2023
Inactive	Liberty Mutual Personal Insurance Company	959584	Agent - Property	10/20/2023	10/31/2023
Inactive	State Farm Fire and Casualty Company	301809	Agent - Casualty	3/5/2024	4/12/2024
Inactive	State Farm Fire and Casualty Company	301809	Agent - Property	3/5/2024	4/12/2024
Inactive	State Farm Mutual Automobile Insurance Company	301732	Agent - Casualty	3/5/2024	4/12/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Fx Insurance Agency, LLC	646184	Agent - Casualty	4/15/2024
Active	Fx Insurance Agency, LLC	646184	Agent - Property	4/15/2024